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Oroya Fever

Bartonellosis


Presentation

  • In modern Peru, symptomatic patients who have acute-phase bartonellosis typically present with a febrile illness and systemic symptoms caused by profound anemia; most patients respond successfully to treatment with chloramphenicol.[ncbi.nlm.nih.gov]
  • Approximately one third of patients present with opportunistic infections due to non-typhoid Salmonellas (i.e.[doi.org]
Inguinal Lymphadenopathy
  • Among the 47 patients with lymphadenopathy, 25 had generalized lymphadenopathy, 18 had cervical lymphadenopathy only, 2 had inguinal lymphadenopathy, and 2 had axillary lymphadenopathy.[doi.org]
Fever of Unknown Origin
  • […] of unknown origin, neuroretinitis, encephalitis, culture-negative endocarditis and peliosis or bacillary angiomatosis.[patient.info]
  • There are 20 other members of the Bartonella genus [1,24-26], which includes B. henselae (implicated in fever of unknown origin, Bacillary Angiomatosis, Cat Scratch Disease, Bacillary Peliosis, osteomyelitis, and other diseases), B. clarridgeiae (implicated[scielo.br]
Respiratory Distress
  • These have included the use of corticosteroids for respiratory distress, red blood cell transfusions for anemia, pericardiectomies for pericardial tamponades, and other standard treatments.[en.wikipedia.org]
  • Neurological complications (i.e. altered mental status, ataxia, seizure, agitation, coma), heart complications (i.e. congestive heart failure, pericardial effusions, myocarditis) and respiratory complications (i.e. adult respiratory distress syndrome)[dx.doi.org]
Aspiration
  • In 1885, Peruvian medical student, Daniel Carrion, infected himself with aspirates from the skin lesions and died of Oroya fever. This looked like proof that Oroya fever and a verruga wart were one disease.[tsunodalaboratory.blog.fc2.com]
  • He died in 1885 after two self-inoculations of an aspirate of the "Peruvian Wart" of a patient, in an attempt to describe the evolution of this disease [4,10].[scielo.br]
Overeating
  • Carrión's disease is endemic to high-altitude valleys of the South American Andes, and the first reported outbreak (1871) resulted in over 4,000 casualties.[ncbi.nlm.nih.gov]
  • Actions (login required) Edit record (repository staff only) Downloads per month over past year CORE (COnnecting REpositories) related articles[usir.salford.ac.uk]
  • The lesions continuously enlarged in size over the following three weeks. They were removed by the patient and resulted in light bleeding.[dx.doi.org]
Systolic Murmur
  • The most common signs were hepatomegaly, lymph node enlargement, pallor, and a systolic murmur.[scielo.br]
Heart Murmur
  • Some studies have suggested a link between Carrion's disease and heart murmurs due to the disease's impact on the circulatory system.[en.wikipedia.org]
Subcutaneous Nodule
  • Additionally subcutaneous nodules were distributed over the trunk and extremities. Hematologic exams showed a moderate anemia. Serologic studies for HIV and Treponema pallidum were negative.[dx.doi.org]
Papilledema
  • Funduscopic abnormalities included flame-shaped hemorrhages in 7 patients, cotton-wool exudates in 4 patients, and bilateral papilledema in 1 patient.[doi.org]
Neurologic Manifestation
  • We have described several severe manifestations of acute bartonellosis, including anasarca in 6 patients, neurologic manifestations in 14 patients, and a pericardial effusion in 7 patients.[doi.org]
Penile Lesion
  • At the time, the miliary warts had disappeared, including the penile lesion, and the size of the nodular lesions had decreased by approximately 50%.[dx.doi.org]

Workup

Staphylococcus Aureus
  • S. dublin, S. typhymurium, S. anatum ), sepsis by Shigella dysenteriae, Enterobacter, Pseudomona aeruginosa, Staphylococcus aureus, pneumonia by Pneumocystis jirovecii or reactivation of tuberculosis, toxoplasmosis, and histoplasmosis.[dx.doi.org]

Treatment

  • Rifampin or macrolides are also used to treat both adults and children.Because of the high rates of comorbid infections and conditions, multiple treatments are often required.[en.wikipedia.org]
  • There are nationally standardized treatments for the acute phase, which consist of ciprofloxacin, and alternatively chloramphenicol plus penicillin G. However, most of the treatments are based on evidence from reported cases.[scielo.br]
  • In modern Peru, symptomatic patients who have acute-phase bartonellosis typically present with a febrile illness and systemic symptoms caused by profound anemia; most patients respond successfully to treatment with chloramphenicol.[ncbi.nlm.nih.gov]
  • The treatment was initiated with oral ciprofloxacin (500 mg BID) for 10 days. On the fifth day of treatment there was a decrease in the size of the miliary lesions. The patient was released and returned five days after completing treatment.[dx.doi.org]

Prognosis

  • Bartonella bacilliformis anemia has a very severe prognosis, due largely to the occurrence of intercurrent infection by enteric organisms.[bloodjournal.org]
  • Prognosis Usually self-limiting. Trench fever re-infection may occur within 3-6 months because antibodies do not give full protection.[patient.info]
  • The finding of anasarca appears to serve as a marker of a poor prognosis, because 3 of those 6 patients died.[doi.org]

Etiology

  • In 1920, Hideyo Noguchi from the Rockefeller Institute was able to culture the etiological agent of Oroya fever and confirmed the common etiological agents of both Oroya fever and verruga peruana, when he inoculated monkeys and was able to cause both[antimicrobe.org]
  • Sentences Mobile "' Alberto Barton "', was a Peruvian microbiologist who discovered the etiologic agent of Carrion磗 disease or Oroya fever .[eng.ichacha.net]
  • Tyler: Etiology of Oroya fever. XIV: The insect vectors of Carrión’s disease. The Journal of Experimental Medicine, New York, 1928, 47: 993-1008.[whonamedit.com]
  • Alberto Barton , a Peruvian microbiologist, identified Bartonella bacilliformis within erythrocytes in 1905, an announced the discovery of the etiologic agent (Barton bacillus) in 1909, which was called Bartonella bacilliformis .[wikidoc.org]
  • Etiology of Oroya fever: XIV. The insect vectors of Carrion’s disease. J Exp Med. 1929; 49:993–1008. pmid:19869598 View Article PubMed/NCBI Google Scholar 7. Ilher GM.[journals.plos.org]

Epidemiology

  • Carrion's Disease constitutes a health problem in Peru because its epidemiology has been changing, and it is affecting new areas between the highland and the jungle.[scielo.br]
  • Although initially Oroya fever was epidemiologically associated with ticks (13), it rapidly became evident that phlebotomine sandflies (particularly Lutzomyia verrucarum) were the vectors.[freethesaurus.com]
  • Keywords: Bartonellosis; Bartonella bacilliformis ; Carrion's disease; Epidemiology; High Forest; Peru.[dx.doi.org]
Sex distribution
Age distribution

Prevention

  • The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.[cdc.gov]
  • At the time, the G7 group made a firm commitment to advance the fight against these illnesses by supporting research in this area and investing in prevention and control efforts [ 21 ].[idpjournal.biomedcentral.com]
  • This may be due to the low-income nature of the main regions affected, which results in a low number of cases being reported, as well as a high number of previously exposed inhabitants, of up to 45% [ 2 ], who have developed partial immunity that may prevent[journals.plos.org]
  • Current research is being done by the Tropical Disease Institute (TDI) at Ohio University and Centers for Disease Control and Prevention (CDC) in Atlanta.[microbewiki.kenyon.edu]

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